by Soon Kyu Choi
In January 2008, four officials representing the Ministry of Public Health (MoPH) of the Democratic People’s Republic of North Korea (DPRK) visited tuberculosis (TB) facilities in the San Francisco Bay Area with financial sponsorship from Stanford University. MoPH representatives met with Stanford University TB specialists to request assistance in funding, building and operating a modern TB reference laboratory in the North Korean capital, Pyongyang. This initial meeting became the start of a strong partnership amongst Stanford Bay Area TB Consortium (Stanford/BATC), the Nuclear Threat Initiative/ Global Health and Security Initiative (NTI/Global Health and Security Initiative), Christian Friends of Korea (CFK), and the DPRK’s MoPH. “Engaging North Korea on Mutual Interests in Tuberculosis Control,” presented by Dr. Sharon Perry at the Korean Economic Institute in Washington D.C. in February 2011, outlines the process and results of this successful partnership and project.
World Health Organization (WHO) ranks North Korea seventh or eighth in the WHO designated 22 high-burden countries. It has the highest incidence rate of TB outside of Sub-Saharan Africa and is a major threat to its neighbors, South Korea and China. According to Dr. Perry and her co-authors, the TB situation in NK is especially dangerous for three reasons. One, it is in diplomatic isolation—ineligible of receiving basic health sector development funds from the World Bank, International Monetary Fund, and Asia Development Bank. Furthermore, international and bilateral aid programs have increasing withdrawn funding in accordance with aggressive North Korean behavior. Two, the North Korean health care system is based on the Soviet Union system of centralized administration and sanatorium care. This system deteriorated in the face of economic conditions and ultimately, greatly contributing to the spread of multi-resistant TB in former Soviet Union countries. A similar scenario is likely happening in North Korea. Finally, inaccurate reporting, food shortages and other infectious diseases, such as measles, are contributing to a population with weakened immune systems.
In October 2010, the DPRK opened its first TB laboratory to the public. The lab would provide quality assurance and culture and drug-susceptibility testing of TB. On a more macro-level, the lab fills an important “blind spot” for TB control in Northeast Asia and emphasizes the critical role that public-private partnerships can play in a vacuum of diplomatic relations. Public-private partnerships are gaining importance both within the U.S. and abroad as nonprofits, government, and private agencies are learning that collaboration and cooperation can be a powerful approach to tackling complex issues and projects.
Much of the literature on public-private partnerships focuses on the importance of communication, leadership, goal setting, funding, capacity, and other functions of the collaborating organizations. These are indeed important components to a successful partnership. The partnership above was successful because it had the right people and organizations, sufficient funding, and strong communication and a long-term commitment from all partners involved to the singular goal to building a TB lab in North Korea. The literature also stresses the benefits of public-private partnerships, mainly the ability to bring together different resources and approaches to problems.
This case study brings another benefit of public-private partnerships to light: the ability to fly under the radar to deliver necessary humanitarian aid to countries operating outside the international political and economic system. It also introduces the idea that diplomatic and official relations are not a necessary precondition for individuals and organizations to become active players in international issues they are passionate about. This characteristic broadens the realm of goals and activities for public-private partnerships, and should continue to be explored both within developed and developing countries.